Case: 62 years old male is transferred from the oncology floor with severe respiratory depression requiring intubation. A review of medical records didn't show any significant exposure to any pertinent drugs except the fentanyl dermal patch which he is using for the last few months without any side effects. Transferring team informed that prior to the event patient was feeling very cold and the nurse applied warm blankets.
Answer: Fentanyl dermal patch (trade name = Duragesic) is highly sensitive to heat exposure of any kind including heating pads, electric blankets, heat or tanning lamps, sunbathing, hot baths, saunas, hot tubs, and heated water beds. Heat increases fentanyl absorption and may result in fatal overdosing.
#toxicity
References:
1. Newshan G. Heat-related toxicity with the fentanyl transdermal patch. J Pain Symptom Manage. 1998 Nov;16(5):277-8. doi: 10.1016/s0885-3924(98)00100-6. PMID: 9846020.
2. Kriikku P, Ojanperä I, Lunetta P. Death in Sauna Associated With a Transdermal Fentanyl Patch. Am J Forensic Med Pathol. 2020 Dec;41(4):313-314. doi: 10.1097/PAF.0000000000000565. PMID: 32740103.
3. Hessulf F. Can't take the heat: sauna and Fentanyl patch intoxication. Clin Toxicol (Phila). 2019 Mar;57(3):219. doi: 10.1080/15563650.2018.1499932. Epub 2018 Aug 10. PMID: 30095280.
No comments:
Post a Comment